Effects of Exercise Training in Heart Transplant Recipients: A Meta-Analysis

Abstract

Objectives: Muscle wasting and exercise intolerance are common in heart transplant recipients. Most studies on the effects of exercise training have used relatively small sample sizes and are heterogeneous in nature. The purpose of this meta-analysis was to systematically review the relevant studies and investigate the effects of exercise training on exercise capacity and muscle strength in heart transplant recipients. Methods: A systematic search was adopted from electronic databases and relevant references, using medical subject heading key words related to heart transplantation and exercise. Only randomized controlled trials with exercise intervention versus usual care were included. The data were expressed as the weighted mean differences with 95% confidence intervals (CIs). Results: Altogether 6 studies were included. Peak oxygen consumption (VO₂) was reported in 4 trials (117 patients), and muscle strength was reported in 3 trials (67 patients). Peak VO₂ was significantly increased by 2.34 ml/kg/min (95% CI 0.63–4.05). One-repetition maxima of the chest press (23.28 kg, 95% CI 0.64–45.91) and leg press (28.84 kg, 95% CI 5.70–51.98) were significantly improved by exercise training. Conclusion: Exercise training is recommended for heart transplant recipients to improve peak VO₂ and muscle strength despite the small number of trials included in this meta-analysis.

Peak oxygen uptake and self‐reported physical health are strong predictors of long‐term survival after heart transplantation

“…To increase physical capacity and prevent long-term complications such as hypertension and diabetes, aerobic exercise after HTx has a positive effect, but their capacity still remains subnormal in most studies (36). High-intensity interval training (HIT) is proven to be a more efficient exercise modality than moderate-intensity continuous training (MICT) in order to increase VO2peak, shown in patients with HF (37), CAD (38), metabolic disease (39), as well as in healthy individuals (40).…”

Healthy aging and age-adjusted nutrition and physical fitness

“…One mechanism seems to be reduced inflammatory activity induced by exercise in patients with coronary artery disease, and measured mainly as reduced C-reactive protein and fibrinogen [65]. Even after heart transplantation, exercise seems beneficial and improves oxygen consumption and muscle strength [66].…”

Physical exercise reduces transplant arteriosclerosis in a mouse aorta transplantation model

“…Therefore, physical exercise has been a longstanding therapeutic tool in treatment algorithms after heart transplantation. 16,17 Only recently, a potential direct effect of physical exercise on the development of CAV was recognized. Nytrøen and colleagues 18 reported on significantly reduced progress of CAV in clinical heart transplantation recipients undergoing high-intensity interval training on a regular basis compared with a control group not performing physical exercise.…”